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General NPI Number Information
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NPI Number | 1124727631
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Entity Type | Individual
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Provider Name | SUSANNA YUNG-LE YEH
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Gender | Female
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Dates
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Enumeration Date | 02/23/2023
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Last Update Date | 02/25/2025
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Provider Practice Location Address
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Address Line | 10 HIGH ST STE 333
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City | BOSTON
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State | MA
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Zip | 02110-1672
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Country | US
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Telephone | 781-430-4471
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Fax |
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Provider Business Mailing Address
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Address Line | 10 HIGH ST STE 333
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City | BOSTON
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State | MA
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Zip | 02110-1672
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DN10000197
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License Number State | MA
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